FMCSA to Propose Dropping Requirement That Drivers With Diabetes Seek Exemption

This story appears in the Oct. 13 print edition of Transport Topics.

The Federal Motor Carrier Safety Administration is scheduled to publish a proposed rule in April that would drop a current requirement that insulin-treated interstate truck drivers with diabetes apply for a special exemption to be issued a medical certification card.

From 1970 to 2003, there was a ban prohibiting any driver with diabetes who used insulin from driving commercial vehicles in interstate commerce.

However, in 2004, FMCSA began accepting applications for diabetes exemptions to allow drivers to be given medical certificates on a case-by-case individual assessment every two years.

Congress in 2005 required FMCSA to drop the exemption requirement altogether.

Through 2013, 4,299 drivers have requested the exemption, but only 2,778, or 64%, have been granted, according to agency records.

Those drivers who have been granted exemptions must comply with requirements ranging from carrying insulin and glucose monitors with memory to maintain a daily record of actual driving time to correlate with daily glucose measurements.

Drivers also are required to report to the agency any episode of severe hypoglycemia, on or off the road.

The process of obtaining an exemption often takes three to four months, but the agency can legally take up to 180 days to complete the process, including publication of driver names in the Federal Register prior to approval, said Katie Hathaway, managing director of legal advocacy for the American Diabetes Association.

The proposal to drop the exemption requirement has been years in the making, and delayed several times.

FMCSA has attributed the delays to a “lack of staffing and unanticipated issues requiring further analysis.”

“This issue of appropriate medical certification or evaluation of individuals with diabetes, and particularly those that use insulin, has been an advocacy issue we’ve been working on for 15 to 20 years,” Hathaway told Transport Topics. “But we’re in a tough position advocacy-wise because the exemption program is working. But we would like for this [to be] taken out of the exemption process because it’s just another hurdle for somebody to keep their job.”

Hathaway said that the more than 3,100 mostly Type 2 or “adult-onset” diabetic drivers she estimates have been granted exemptions to date have not had significant problems managing their condition while driving.

When the exemption rule was first issued in 2003, the Owner-Operator Independent Drivers Association and the National Private Truck Council generally supported it.

American Trucking Associations initially opposed changes to the requirements for drivers with diabetes but since has gone on record to support the exemption process. However, ATA remains opposed to changing the qualification parameters, said Sean Garney, ATA manager of safety policy.

ATA is waiting for the proposed rule that would drop the exemption requirement before taking a position, Garney said.

Despite general trucking industry support, the exemption program was opposed by the Insurance Institute for Highway Safety and the Advocates for Auto and Highway Safety.

IIHS said that the working conditions of interstate truck drivers are not compatible with the medical needs of people with insulin-treated diabetes.

“Long and irregular hours, night responsibilities, variations in the amount of exercise and variations in the amount of food consumed are integral aspects of longhaul trucking,” IIHS said.

A 2006 FMCSA study presented to the agency’s medical review board produced somewhat inconclusive results, largely because the samples included the general driving population, not just truckers.

“CMV drivers are exposed to far more risk than the average driver by virtue of the fact that they are driving for longer periods of time over far greater distances in a large variety of traffic environments,” the FMCSA study concluded.

FMCSA’s medical review board has supported the exemption program, but not for passenger carrier drivers or drivers who hauled hazardous materials, Hathaway said.

The lack of an adequate number of interstate truck drivers providing input at the time of the 2006 study, she said, was the result of the decadeslong prohibition on drivers with diabetes.

Gina Pervall, medical director for Occupational Medicine Services at Johns Hopkins University and chairman of FMCSA’s medical review board, said,”The agency is making some plans regarding the issue. I think it’s something that we’re going to be looking at.”